HBV reactivation in patients undergoing cytotoxic chemotherapy

Pre-chemotherapy hepatitis B virus (HBV) DNA level, steroid use, and a diagnosis of lymphoma or breast cancer are factors associated with HBV reactivation following cytotoxic chemotherapy, find physicians in the British Journal of Cancer.

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Several clinical features, as well as pre-chemotherapy hepatitis B (HBV) viral load, have been associated with an increased risk HBV reactivation.

In this study, physicians form Hong Kong, China, assessed the clinical and virological factors associated with the development of HBV reactivation. They also developed a predictive model to quantify the risk of HBV reactivation.

The team evaluated 138 consecutive cancer patients who were HBV carriers and underwent chemotherapy.

26% of patients developed HBV reactivation.

British Journal of Cancer

Of these, 128 patients had sera available for real-time PCR HBV DNA measurement.

The patients were followed up throughout their course of chemotherapy and the HBV reactivation rate was determined.

The team compared the clinical and virological features between those who did and did not develop viral reactivation.

They assessed age, sex, baseline liver function tests, HBeAg status and viral load (HBV DNA) prior to the chemotherapy, and the use of specific cytotoxic agents.

The physicians found that 26% of patients developed HBV reactivation.

Multivariate analysis showed that pre-chemotherapy HBV DNA level, the use of steroids and a diagnosis of lymphoma or breast cancer were significant factors associated with HBV reactivation.

Dr Yeo and colleagues concluded, "Detectable baseline HBV DNA prior to…cytotoxic chemotherapy, the use of steroids and a diagnosis of lymphoma or breast cancer are predictive factors for the development of HBV reactivation".

"A predictive model was developed from the current data, based on a logistic regression method".